The Business of Getting Better—and the Best

Injured players are relying on team doctors less and less in their quests to get back on the field. The complicated reasons for getting a second opinion can leave NFL surgeons in an awkward position

Andrew Brandt
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Giants safety Stevie Brown represents another in a growing trend of NFL players who are having surgery performed by someone other than his team’s doctor, opting to have his torn left ACL repaired not by Russell Warren—who was ready, willing and able to operate—but instead by James Andrews.

Warren isn’t just a capable orthopedic surgeon, he’s respected greatly by his peers. This includes Andrews (pictured above), who often finds himself in the tricky position of seeing the patient of a trusted colleague who works for an NFL team and then apologizing for doing so. As Jenny Vrentas reports in her story about Brown’s surgery, Andrews left the operating room and called Warren with an update, telling him, “I apologize for him being down here; I don’t need to be doing any of your guys. It always makes me feel bad. Anyway, we got him fixed good.”

During my 10 years in the Packers’ front office, we preferred players to have surgery done “at home” with our team doctor (or a local specialist, if needed) so players could rehabilitate while having regular contact with the surgeon who did the procedure. During my time in Green Bay, very few players sought outside surgeries. That, however, has been changing in recent years throughout the league. There are a couple reasons fueling this migration.

The first is the constant need—real or perceived—for agents to prove their worth. The agent business becomes more cutthroat every year, with greater numbers of aspiring agents competing for the same number of players. Poaching is rampant, with players constantly hearing about (or from) other agents who offer something the player hasn’t had: increased personal attention, an upgraded contract, additional endorsement deals or access to “the best” medical care.

Many agents have “their guy,” and that guy often happens to be Andrews. He is the game day doctor for the Redskins, but has also operated on the fast-healing ACLs of Adrian Peterson, Robert Griffin III and Brian Cushing. Getting their clients in for a second opinion and/or surgery with Dr. Andrews is perceived as an added value to players, and agents certainly sell it that way.

The other reason more players are seeking treatment elsewhere is a growing distrust of team doctors. Agents, teammates and the NFL Players Association stimulate this lack of trust. Specifically, the union emphasizes to players 1) their collectively bargained right to seek an outside second opinion and/or surgery for an injury; 2) documented issues with a couple of team doctors, who are often seen as generalists rather than specialists, and 3) the team doctor’s perceived inherent loyalty to the team, rather than the player.

The new reality in medicine is clear: second opinions and outside surgeries have become a staple of doing business in the NFL.

More on ACL Injuries

Stevie Brown’s ACL Surgery: 63 Minutes to a New Knee

Can a Soccer Doctor Save NFL Players’ Knees?

From Jock to Doc: The RG3 Knee Surgeon You Don’t Know


Team doctor positions are nothing but paid sponsorships.  Don Shelbourne (Travis Pastranas preferred ortho surgeon) in Indy was the Colts team doc for a long time. Then a decade ago they wanted him to PAY THEM for the honor.  $400K!  Shelbourne said no thanks.  The paid gig nature of most team docs positions is not known to the public.  The main reason players go elsewhere, is team docs are often not the best at their specific injury. 


Completely disagree with the negative comments here.  It's reasonable to wonder why we've seen such in increase in players having surgery by non-team affiliated doctors over the past few years.  I learned something from this article; namely that agents and the union play a large role in this process.  Initially, I presumed players were simply buying into the "brand" of Dr. James Andrews (full name heard countless times on ESPN throughout the year).  I didn't realize there were other factors at play.  

Look, not every topic requires a novel.  Honestly, it's nice to have a concise summary of the issue.  Perhaps Andrew could have expanded more on the "documented issues with team doctors," but count me as someone who enjoyed the article for all it was worth.

And if you haven't read Andrew's other columns, you're doing yourself a disservice.  Excellent insight into the business of the NFL.

Mike N
Mike N

Is RG3 the only athlete Andrews has operated on?

You'd think that seeing him at every WAS game for the last 5-6 weeks!


Peter, if this article is an example of what we're going to be getting from your staff...fire ‘em and just do the writing yourself.  This is 466 words to tell us "Players are getting surgery from doctors other than their team doctors because their agents tell them to." This was about as creampuff an article as can be found, and more in line with what I would expect from a high school journalism student.


@DavidRose Calm down. Yes, this was not the most informative article ever on MMQB, but take a look at the rest Andrew Brandt's stuff, usually very interesting. Maybe this is Brandt's Bye-Week?


@DavidRose If Peter was writing all the articles, he would have had no time to write this, and you would not have anything to complain about.